This present invention relates to the field of guide wires used for advancing intravascular devices such as stent delivery catheters, balloon dilatation catheters, and atherectomy catheters within a body lumen. More specifically, the present invention relates to a guide wire with a polymer coating having a textured surface.
Conventional guide wires for angioplasty, stent delivery, atherectomy and other vascular procedures usually comprise an elongated core with one or more tapered sections near the distal end thereof and a flexible body such as a helical coil or a tubular body of polymeric material disposed about the distal portion of the elongated core. A shapable member, which may be the distal extremity of the elongated core or a separate shaping ribbon which is secured to the distal extremity of the elongated core, extends through the flexible body and is secured to the distal end of the flexible body by soldering, brazing, or welding, which forms a rounded distal tip. Torquing means are provided on the proximal end of the elongated core to rotate, and thereby steer, the guide wire while it is being advanced through a patient's vascular system.
Further details of guide wires and devices associated therewith for various interventional procedures can be found in, for example, U.S. Pat. Nos. 4,748,986 (Morrison et al.); 4,538,622 (Samson et al.); 5,135,503 (Abrams), 5,341,818 (Abrams et al.), and 5,345,945 (Hodgson et al.), which are hereby incorporated herein in their entirety by reference thereto.
In a typical coronary procedure using a guide wire, a guiding catheter having a preformed distal tip is percutaneously introduced into a patient's peripheral artery, e.g., femoral or brachial artery, by means of a conventional Seldinger technique and advanced and steered therein until the distal tip of the guiding catheter is seated in the ostium of a desired coronary artery.
There are two basic techniques for advancing a guide wire into the desired location within the patient's coronary anatomy through the in-place guiding catheter. The first is a preload technique which is used primarily for over-the-wire (OTW) devices, and the second is the bare wire technique which is used primarily for rail type systems.
With the preload technique, a guide wire is positioned within an inner lumen of an OTW device such as a dilatation catheter or stent delivery catheter with the distal tip of the guide wire just proximal to the distal tip of the catheter and then both are advanced through the guiding catheter to the distal end thereof. The guide wire is first advanced out of the distal end of the guiding catheter into the patient's coronary vasculature until the distal end of the guide wire crosses the arterial location where the interventional procedure is to be performed, e.g., a lesion to be dilated or a dilated region where a stent is to be deployed. The catheter, which is slidably mounted onto the guide wire, is advanced out of the guiding catheter into the patient's coronary anatomy over the previously introduced guide wire until the operative portion of the intravascular device, e.g., the balloon of a dilatation or a stent delivery catheter, is properly positioned across the arterial location. Once the catheter is in position with the operative means located within the desired arterial location, the interventional procedure is performed. The catheter can then be removed from the patient over the guide wire. Usually, the guide wire is left in place for a period of time after the procedure is completed to ensure reaccess to the arterial location if it is necessary. For example, in the event of arterial blockage due to dissected lining collapse, a rapid exchange type perfusion balloon catheter such as described and claimed in U.S. Pat. No. 5,516,336 (McInnes et al.), can be advanced over the in-place guide wire so that the balloon can be inflated to open up the arterial passageway and allow blood to perfuse through the distal section of the catheter to a distal location until the dissection is reattached to the arterial wall by natural healing.
With the bare wire technique, the guide wire is first advanced by itself through the guiding catheter until the distal tip of the guide wire extends beyond the arterial location where the procedure is to be performed. Then a rail type catheter, such as described in U.S. Pat. No. 5,061,273 (Yock) and the previously discussed McInnes et al., which are incorporated herein by reference, is mounted onto the proximal portion of the guide wire which extends out of the proximal end of the guiding catheter outside of the patient. The catheter is advanced over the catheter, while the position of the guide wire is fixed until the operative means on the rail type catheter is disposed within the arterial location where the procedure is to be performed. After the procedure, the intravascular device may be withdrawn from the patient over the guide wire or the guide wire advanced farther within the coronary anatomy for an additional procedure.
There has been an interest in creating different surface profiles for the guide wire core. The interest arose primarily to address the issue of friction between the contact surface of the guide wire and the catheter lumen through which it passes or the body lumen of the patient. One attempt is the use of a sleeve at the distal portion of the core as seen in, for example, U.S. Pat. No. 5,404,887 (Prather). Another approach to reducing the surface contact between the guide wire and a catheter lumen or body lumen is shown in U.S. Pat. No. 6,296,616 (McMahon).